feat(clinical): reconcile owner-confirmed sign-offs and review state

Merged
BI
1mo ago
+5506-4064

Summary

  • Josh, PsychSift's clinical owner, confirmed on 2 October 2026 that he performed the clinical sign-offs submitted in this PR. The recorded PsychSift reviewer attribution refers to his owner review. See the owner confirmation and docs/evidence/pr-3143-owner-signoff-confirmation.md.
  • The reconciled diff carries 580 additional reviewed records relative to main 00f5e6999c1146ffbde836cd9e6203d8e0c43e55. Existing review dates and content hashes are retained. Earlier comments questioning who performed these reviews are superseded by the direct owner confirmation.
  • Preserve current main content where it changed after the original review. Five newly detected stale approvals (CPT, IPT, prolonged exposure, neuroleptic malignant syndrome, and serotonin toxicity) return to main's pending state. Previously revised forms, Act sections and formulation mechanisms retain their pending state. The original review remains part of Git history; an old pin does not attest later wording.
  • Resolve generated Therapy Compass and site-manifest conflicts by regeneration. Fix test fixtures that depended on unsigned live data, update measured unsigned counts, and report the specifier family as unrouted only while it contains pending universal specifiers.

Areas touched: Clinical reference content, App experience, Answer engine, Prototypes, Knowledge and records

Verification

  • Focused verification: 244 tests passed across the 12 affected clinical-review, source, queue and DOM test files.
  • check:source-acquisitions: Source acquisition ledger passed (113 records).
  • check:clinical-hazard-controls: CLINICAL_HAZARD_CONTROLS_PASS hazards=7 decisions=5 review-dates=strict expired-not-blocking=0.
  • Regenerated therapy assets and static site-content baseline from the reconciled source records.
  • npm run typecheck: completed successfully after the fixture type repair.
  • npm run format completed; check-format-changed: All matched files use Prettier code style!.
  • Additional generated-sheet and CI-scope regression tests passed; forms review sheet is current.
  • Left to CI: full unit coverage, build and production browser checks. The preliminary broad local test run was stopped before fixture repairs and is not passing evidence.

Risk and rollout

  • Risk: clinical review/provenance metadata changes at scale. Current content-pin, attribution, Indigenous-governance, source-adoption and publication guards remain enforced. Tests continue to reject missing/future/invalid reviews and edits after sign-off; no tests or coverage thresholds were removed.
  • Rollback: revert the PR.
  • Provider or production effects: merging main triggers the existing application deployment. This PR adds no migration, changes no dependency manifest, and performs no clinical-provider or live-database operation. Deployment success is a separate observation.

Clinical Governance Preflight

  • Source-backed claims still require linked source verification before clinical use
  • No patient-identifiable document workflow was introduced or expanded without explicit governance approval
  • Supabase target remains PsychSift Production (sjrfecxgysukkwxsowpy)
  • Service-role keys and private document access remain server-only
  • Demo/synthetic content remains clearly separated from real clinical sources
  • Source metadata, review status, and outdated/unknown-source behavior remain conservative
  • Deployment classification/TGA SaMD impact was checked when clinical decision-support behavior changed

This records the owner's existing reviews and preserves content-specific re-review and Indigenous holds. It does not introduce clinical decision-support computation or change its deployment classification. Source review does not adopt a candidate; dictionary approval does not automatically publish a rewrite.

Notes

The rate-limit, Sentry privacy and calendar recurrence fixes originally bundled with this PR have already landed on main via #3147. The ledger reconciliation is already represented on main. They are not new changes in the remaining diff.

Aboriginal and Torres Strait Islander governance holds are retained. Records without written content and records revised after review remain visible as pending; this does not negate the owner's completed review of the original submitted content.